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Organization

AUGUSTA FAMILY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA JOHNSON (COO)
(316) 775-9191
Entity
Organization

Contact information

Practice address
1306 STATE ST, AUGUSTA, KS 67010-1126
(316) 775-9191
(316) 775-0348
Mailing address
1306 STATE ST, AUGUSTA, KS 67010-1126
(316) 775-9191
(316) 775-0348

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5376107
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100359330A
KS
05
100359330B
KS
Enumeration date
12/11/2014
Last updated
12/11/2014
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